Efforts to tackle childhood obesity are making slow progress, but there are glimmers of hope, Victoria Goldman explains…

Data from the latest National Child Measurement Programme in England, published in November 2022, revealed the prevalence of obesity among children in their Reception year decreased from 14.4 per cent in 2020-21 to 10.1 percent in 2021-22.

The prevalence of Year 6 children living with obesity decreased from 25.5 per cent in 2020-21 to 23.4 per cent in 2021-22. In both school years, however, the prevalence of obesity remains higher than before the Covid pandemic.

The data also shows that in both age groups more boys are living with obesity than girls. In Reception, 10.3 per cent of boys were classed as obese compared to 9.9 per cent of girls. In Year 6, the figures were 26.4 per cent for boys compared to 20.4 per cent of girls.

According to the Office for Health Improvement and Disparities, children living with obesity are more likely to have a higher risk of obesity, morbidity, disability and premature mortality in adulthood, including an increased risk of high blood pressure, high cholesterol and diabetes. Many of these children also experience poor mental health and bullying.

Maternal and parental health are significant risk factors for childhood obesity, along with a poor diet, high sugar intake and low levels of physical activity. Obesity may also be driven by behaviour, environment, genetics and culture.

A Nuffield Trust report published in October 2022 revealed that overweight and obesity levels among children at the upper-tier local authority level in England are likely to be higher in areas where there is more childhood poverty, where children have less access to places for physical activity and where there are lower breastfeeding rates.

Childhood obesity strategies

The Royal College of Paediatrics and Child Health 2020 report, State of Child Health in the UK, says all four home nations have published strategies committed to halving childhood obesity by 2030.

These strategies include bans on the marketing of junk food, better nutritional labelling in shops and restaurants, and improving nutrition in school meals, as well as improving weight management services for children and young people. However, many of these plans are still to be implemented.

The government’s policy paper on Tackling Obesity: empowering adults and children to lead healthier lives, published in July 2020, announced plans to ban adverts for foods high in fat, sugar and salt from TV and online sources before 9pm, with the intention of implementing these changes by the end of 2022.

In December 2022, the Obesity Health Alliance (OHA), representing health charities, medical organisations, healthcare professionals and thousands of patients, expressed outrage that this watershed ban is being delayed until October 2025.

Also in December 2022, the RCPCH called on the UK Government to finally implement mandatory guidelines on the amount of sugar and salt that baby foods can contain. The Government released draft commercial baby food and drink guidelines for consultation in 2020, but there are still no limits or restrictions in place.

On a more positive note, a research article published in PLOS Medicine in January revealed that there may have been 5,000 fewer cases of obesity among Year 6 girls in each year since the “sugary drinks tax” came into force in 2018.

The levy was introduced in 2016 to encourage drinks manufacturers to reduce the amount of sugar in their products. However, the team found no associations between the sugar tax coming into effect and changes in obesity levels in children from Reception class or in Year 6 boys.

“It’s hugely encouraging to see that the introduction of the sugar levy is associated with reduced obesity levels in some children,” says John Maingay, the British Heart Foundation’s director of policy and influencing.

“There is now great potential to build on the success of the sugar levy and introduce similar measures on other types of unhealthy foods and drinks, where voluntary programmes have not driven the progress that we so need. We’re also urging the Government to press ahead with restricting junk food marketing to give children a greater chance at living a healthy life.”

Tackling child obesity

Healthcare professionals play an important role in supporting families to tackle excess weight gain in children. The RCPCH encourages healthcare professionals to provide weight management advice, make every contact count, recognise the impact of social determinants on health, and support families in need.

NICE guidelines on obesity, updated in September 2022, stress that using a dietary approach on its own to reduce weight in children isn’t recommended. According to the Association of UK Dietitians (BDA), young children need regular meals and snacks, but their nutritional needs change as they get older.

Children under five years have high requirements for energy (kcals) from nutritious foods, but children over five should follow a healthy diet suitable for all the family.

NHS exercise guidelines for children and young people recommend that children and young people aged five to 18 years aim for an average of at least 60 minutes of moderate or vigorous intensity physical activity a day, along with varied strengthening activities.

According to NICE guidelines, children should spend less time sitting watching television, using a computer or playing video games. They should be given more opportunity to keep active, from using the stairs, walking and cycling to structured physical activity such as football, swimming or dancing.

[BOX]

Eating disorders in children and teenagers

In March 2022, NHS England revealed that more young people than ever before were receiving treatment for eating disorders. Almost 10,000 children and young people started treatment between April and December 2022, with record demand for services.

Some possible signs of eating disorders include individuals making rules about what or how they eat, eating a restricted range of foods, binge eating, and/or having a negative self-image about their weight and appearance.

Professor Prathiba Chitsabesan, psychiatrist and NHS associate clinical director for Children and Young People’s Mental Health, advises young people and their families to use trusted online resources if they have concerns and want to seek help.

Information about eating disorders is available on the NHS website, as well as from charities such as BEAT (www.beateatingdisorders.org.uk).